Carepay builds a smart healthcare payment system in multiple countries currently in Africa. When it comes to digital transformation, it is surprisingly slow in hospitals and insurance companies, especially in Africa. The Carepay platform caters three type of user categories: participant, healthcare providers, and payers. It enables people to pay for their healthcare efficiently and transparently.
SaaS Software to Revolutionize Healthcare Payments in Africa
Time
Oct 2019 – Now
Services
Design system setup
Concept validation
Product testing
Wireframe & prototype
UI
Challenges
Traditionally, medical claims are handled in paper. This is not only in Africa, but also many places in Europe. In Kenya, it takes about a month to send a claim from a hospital to a payer. If there is any dispute, the claim will be send back to the hospital to request changes. And afterwards send to the payer again. You an imaging this will take months to settle a claim.
With this system, we are able to increase efficiency 26 times from treatment date to claim approval. Before it took averagely 77 days. Now it takes 3 days.
Having said that, before I joined Carepay, UX hardly existed and was mostly ignored. This result in a product that is now well thought through. There was no consistent logic nor any design system behind it. So the overall user experience was … not very pleasant, if I put it nicely.
Good new was, there was a lot we can improve 😃
Fig: Screenshot of an old page. I was pretty shocked when I saw this 😵. Our clients had to use this… I could feel their pain.
My role
One of my main purposes was to setup UX vision and processes and built up best practises from scratch for the whole company. This takes a lot of time and effort for the organization to adopt new way of working. We as a team are still working hard on it. But at this stage, I can proudly say, UX has become the corner stone in the development process. We are able to validate concept and test solution before it gets built. This was un-imaginable just 1 year ago.
My goal within Carepay’s eco-system is to help the insurance companies in both public and private sector to:
- Setup insurance programs smoothly
- Handle claims fast and efficiently
- Release payments to hospitals seamlessly
Fig: Screenshot of the design library, still work in progress.
Claim handling
I’ve been working in the squads of Claim settlement. It is one of the core services that Carepay offers.
When patients visited hospital and doctors prescribes treatments, it will then land at the payer’s side as a claim. The claim managers need to check if this claim make sense and therefore decide whether to pay it or not.
The aim is to provide Fast, Fair and Factual support to claim managers. I was the designer to lead a few features that can help the them process claims more efficiently and accurately:
- Adjusting line item, including reject, adjust value and change insurance cover.
- Cover rule support. This means the system is able to check set rules such as age or gender restriction, visit limits, price over charge, etc.
- Claim automation. Ultimately, we want to automate the claim processing. At this stage, the system recommendation is shown as suggestion and will be compared to the claim manager’s final decision. This will then feed increase accuracy.
Interview
When I started working on claims handling, the understanding of the users – claim managers are very limited. We were lack of basic knowledge such as:
- What is the goal of claim manager’s?
- How are the teams organised and how do they setup priority?
- What is a typical working day look like?
- What is the most difficult part of work and what is the current work around?
- With whom are they interacting with?
- …
We were able to set up scripted interviews with users from different clients and just chat to understand them. In the end we were able to establish a foundation of understanding how claim managers operate, how their day-to-day look like and how they go about the process of handling claims. The result was translated into a persona. For later stages we also refer to ‘Bernard ’ to align vision and delivery.
Fig: Interview script
Fig: Persona
Usability study
Next to the scripted interview, we also did a usability study with the users to see how they use with our product in its entirely and also check their interaction with the recent added functions. We created a UX environment on the current ACC built. This way we can make sure the testing environment is not influenced by any deployment or QA testing, and we can prepare different scenarios so that all users can have a clean state to participant.
Out put were documented in detail on Confluence page. Product maturity were measured on the product wall. Within our company, we had never had such comprehensive understanding of the user and how they use our product. In the end, I had to present the method, process and result in multiple occasions including the senior management. It was used as an example to inspire and roll out to other squads.
Fig: screenshot part of the report Confluence page
During the process, there was a newly hired a UX researcher in Nairobi who had a lot of field knowledge but little UX skill. To help him on board, I took him through the steps guided him on how to setup such researches, tips and tricks, and compose reports. He’s still learning but already confident to conduct a session by himself.
Current version
With a solid base understanding of the user, we were able to deliver the above mentioned features. We could design more ‘on spot’ and are able to explain the value to the team. We got very positive feedback from the user especially on the adjusting line items. This hugely increase their work efficiency. Alone the process new problems are uncovered together with new opportunities. It is a continuous effort to keep understanding the user and improving our product. Looking at what we have now compared to what was like a year ago. I’m pretty happy with the progress.
Fig: Old payment registration portal vs. prototype of new payment concept
Payment settlement
Payment is another core business Carepay provides. It smoothes the pay out flow from insurance companies to hospitals, and facilitate the reconciliation on both sides as well.
When I joined, the payment module merely serves as a registration portal. This means there was no money flows through our system, nor were we integrated with any banks. The finance users only come to our platform and make a file after transaction happened.
Moving to the actual money flow has a lot of benefits, such as discount negotiation, speedy payment, real time data monitoring and reconciliation, charging fees (sits on their money). With one of our key client/partner, we started moving to the real money flow instead of registration portal.
I did similar study as what was done at Claims handling. With the understanding of end users, I created concepts for validation. Since the whole thing was almost entirely new, there were a lot of internal alignment with different stakeholders. I’m currently still working on it. Below is sneak peak of the 2nd iteration that was proposed to the client.
Fig: Old payment registration portal vs. prototype of new payment concept
Other responsibilities
Above are the two main areas that I mostly focused on. Other than that, I was also responsible for the design of insurance programs setup and dashboard for management to view data and download files.
I’m very excited that I could work on various fields and take a lot of responsibility. And I’m also super happy that I joined a company in scale up phase which gave me the chance to setup the UX playground 😉